John Lawrence Shannon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AR2426 Issued in AR

Practice address

2704 E Nettleton Ave
Jonesboro, AR 72401-4529

Phone

(870) 932-9886

Fax

(870) 932-8037

NPI assigned

Apr 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952421836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 E NETTLETON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014529",
            "telephone_number": "870-932-9886",
            "fax_number": "870-932-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 E NETTLETON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014529",
            "telephone_number": "870-932-9886",
            "fax_number": "870-932-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "JOHN",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "AR2426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Shackelford
• David A Shade, M.S., LPE-I
• Stormy Shankle
• Jay Shanks
• Shanna Legacy Homecare LLC
• Khadijah Sharks
• Tomeko Sharks
• Anne Marie Sharp
• Heather Sharp, MHPP
• Lyndsey Sharp

• General Practice Dentistry in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.